Biomedical subjects

Yoram Barak

Publications and source records attributed to Yoram Barak.

At least 19 recordsLinked to original sources

PubMed2006

Cognitive fatigue in multiple sclerosis: findings from a two-wave screening project.

BACKGROUND: Multiple sclerosis (MS) patients commonly suffer from fatigue and define it as one of their most disabling symptom profoundly disrupting their lives. However, the relationship of fatigue to cognitive functions and its impact on quality of life have not been widely studied. AIM: To define (1) "cognitive fatigue", (2) survey its frequency and (3) characterize severity and impact on quality of life in MS patients in the first 10 years of the disease. METHODS: A two-wave design was utilized to enrich the studied population in subjects whose fatigue is significant. In the first wave, fatigue was measured by the self-reported fatigue severity scale (FSS) in randomly selected MS patients from our computerized database. Patients responding to the 9th item of the FSS i.e., "Fatigue interferes with my work, family, or social life" by a grade of 3 or higher (of 7) were further assessed (wave two) by the fatigue impact scale (FIS) and the RAYS quality of life questionnaire. RESULTS: Of the 259 patients that completed the first-wave screening, 158 patients (61%, 118 females, mean age 41.1+/-9.2 years, mean disease duration 6.2+/-5.5 years) satisfied the additional criterion and were defined to suffer from significant fatigue. The great majority of these patients-91.7%-had a relapsing-remitting disease course, mean FIS score was 77+/-25.9 and their mean EDSS was 2.9+/-2.6. Fatigue was reported to occur most of the day in 30.9% of patients, persist in 69% for more than 1 year, and in 59.8%, it was reported not to be associated with effort. No correlations were found between age, gender, disease duration or neurological disability and FIS cognitive subscale score. Significant correlations were found between the FIS cognitive subscale score and the three domains (physical, psychological and social-familial) of the RAYS quality of life questionnaire (p<0.001). CONCLUSIONS: Cognitive fatigue was found in more than half of MS patients in the first decade from onset that were particularly selected for significant fatigue in their lives. This aspect of fatigue correlated with all quality of life domains and especially with psychological everyday tasks.

Adult↗

PubMed2006

The immune system and happiness.

Human ability to experience negative and positive emotions has an evolutionary perspective and the presence of feelings designed to influence behavior should thus be reflected in physiological and immune interactions. The complex interactions between the immune system and the central nervous system have been studied extensively in schizophrenia and depression. On the other hand, effects of positive human emotions, especially happiness, on physiological parameters and immunity have received very little attention. Emotions are intimately involved in the initiation or progression of cancer, HIV, cardiovascular disease, and autoimmune disorders. The specific physiological responses induced by pleasant stimuli were recently investigated with the immune and endocrine systems being monitored when pleasant stimuli such as odors and emotional pictures were presented to subjects. The results revealed that an increase in secretory immunoglobulin A and a decrease in salivary cortisol were induced by pleasant emotions. The mechanisms by which positive as opposed to negative states are instantiated in the brain and interact with the immune system are not yet understood. The present review investigates relations among physiological measures of affective style, psychological well-being, and immune function. There is data to support the hypothesis that individuals characterized by a more negative affective style poorly recruit their immune response and may be at risk for illness more so than those with a positive affective style. Future research is needed to expand our knowledge of the physiological and immune interactions of positive emotional states and their beneficial effects on health.

Brain↗

PubMed2006

Perspectives in multiple sclerosis health care: special focus on the costs of multiple sclerosis.

Brain disorders are amongst the leading causes of disease and disability worldwide, accounting for 35% of the burden of all diseases in Europe. Despite their enormous personal and national impact the knowledge of the financial and economic impression of brain disorders has been relatively little researched. Recently it has been estimated that there are nearly 400,000 multiple sclerosis (MS) patients in Europe, which is 0.003% of all brain disease patients in the continent. In MS economic consequences are predominantly the early loss of work capacity and the impact of physical and psychological disabilities in a population of young adults, hospitalization during severe disease exacerbations and the need for assistance in activities of daily living. In the last decade the introduction of new immunomodulatory treatments led to an increase in direct costs due to the cost of these drugs, but also led to a more intensive management of patients. However, most studies of MS costs were carried out prior to the widespread use of newer treatments. In the present study we estimated the economic impact of MS in Israel and compared the traditional-vertical management model with the integrated-multidisciplinary model of health service delivery following the introduction of immunomodulatory treatments. Mean direct health cost was 8,554 euros and 5,599 euros in the traditional and integrative models, respectively (p<0.01). After 1-year follow-up, full-time employment decreased by 10% in the traditional model and increased by 17% in the integrated model (p<0.05). Analysis of variance demonstrated that the model of service delivery explained most of the difference in cost between the two models. Compared to mean annual costs in Europe that are estimated at 23,695 euros per case the cost of health services in Israel by MS patients is significantly lower. MS represents a high economic burden to society. In line with the findings from 15 studies published in Europe, we can conclude that studies agree with the following findings: a) costs outside the healthcare system, non-medical costs and informal care dominate the costs of MS, b) costs increase with increasing severity of the disease and c) an integrated service delivery model that is satisfying to patients on the one hand and cost effective on the other is to be recommended.

Cost of Illness↗

PubMed2006

Suicide attempts amongst elderly bipolar patients.

BACKGROUND: Bipolar disorder is associated with high risk of suicide. In the elderly suicide rates are the highest of all age groups. There is a paucity of data regarding suicide amongst elderly bipolar patients. Mood stabilizers and particularly lithium are established as "antisuicide" compounds. OBJECTIVE: We aimed to evaluate the association between exposure to psychotropic drugs and suicide attempts in a cohort of elderly patients suffering from bipolar affective disorder (BAD). METHOD: This was a preliminary, retrospective, matched, case-controlled evaluation over a 10-year period. All records of admissions of patients with BAD (ICD-10) were assessed. The index group comprised all patients who had attempted suicide in the month prior to admission. The control group consisted of the next admission of a patient suffering from BAD, matched for sex and age who had not attempted suicide in the month prior to admission. RESULTS: The index group during the period 1995 to 2004 consisted of 16 patients, (8 men and 8 women.), mean age 74.8 +/- 1.3 years. The control group patients (N = 16) were matched for age (mean 74.3 +/- 1.5 years) and sex. The number of patients who had a history of a suicide attempt was significantly greater in the index group (7/16 vs., 2/16; p = 0.039). In the control group patients treated by both a mood stabilizer and an antidepressant were at a significantly lower risk for recent suicide attempt (p = 0.047). LIMITATIONS: Sample size is small, treatments were not standardized and data were collected retrospectively. CONCLUSION: Elderly BAD patients treated with mood stabilizers and antidepressants may be at reduced risk of attempting suicide. These findings need support from prospective randomized trials.

Aged↗

PubMed2006

Increased use of mental health services related to isotretinoin treatment: a 5-year analysis.

BACKGROUND: The association between exposure to Isotretinoin, the development of depression and suicide attempts is controversial. OBJECTIVE: To retrospectively assess pattern of utilization of mental health services in the Israeli Defense Forces (IDF) during a 5-year period for all subjects exposed to Isotretinoin in comparison to a control group consisting of army conscripts suffering from psoriasis. All subjects were young adults (18 to 21 years old) in compulsory military service. METHOD: Exposure to Isotretinoin mandates reporting and marking as a coded medical profile in the IDFs' computerized medical record of each conscript and soldier. Medical data, tracked by military medical profiles, were summarized from medical records of all subjects treated by Isotretinion during the years 1999-2003 and for the control group for the same period. Use of mental health services was the a-priori defined primary outcome measure. RESULTS: During the study period 1419 subjects were exposed to Isotretinoin and 1102 suffered from psoriasis. Utilization of mental health services was highest for the index group wherein 17.2% (245/1419) of subjects were evaluated or treated compared to 12.5% in the control group (psoriasis). The inter-group differences were statistically significant; Chi-square=15.9 (df=2), p=0.0003. CONCLUSIONS: We suggest that psychiatric evaluation be regularly undertaken prior to initiation of Isotretinion treatment in young adults at risk, as well as providing follow-up visits during and at completion of treatment.

Acne Vulgaris↗

PubMed2006

Antidepressants reduce the risk of suicide among elderly depressed patients.

Treatment with selective serotonin reuptake inhibitors (SSRIs) may increase the risk of impulsive acts including suicide, while data from epidemiological studies suggest that the effect of SSRIs in the elderly may be beneficial. We aimed to evaluate the association between exposure to antidepressants and suicidality in a cohort of elderly patients suffering from major depressive disorder (MDD). This was a retrospective matched case-controlled evaluation over a 10-year period. All records of admissions of patients with MDD (ICD-10) were assessed. The index group comprised all patients who had attempted suicide in the month prior to admission. The case-controlled group was the next admission of a patient suffering from MDD, matched for sex and age who had not attempted suicide in the month prior to admission. The index group during the 10-year period (1995-2004) consisted of 101 patients suffering from MDD who were hospitalized following a suicide attempt. Mean age for the group was 76.5+/-6.6 years; there were 42 men and 59 women. The control group patients (N=101) were matched for age (mean 76.6+/-6.9 years) and sex. The proportion of patients exposed to an antidepressant was significantly greater in the control group, than in the group of patients who had attempted suicide (58 vs 42%, odds ratio 1.94 (95% CI: 1.1-3.4), p=0.019). SSRIs were prescribed in 29% of patients in the control group vs 21% of patients in the index group (p=0.03). It is of interest to note that concomitant prescription of benzodiazepines also conferred a protective effect. In conclusion, elderly depressed patients treated with antidepressants may be at reduced risk of attempting suicide. These findings need support from prospective randomized trials.

Aged↗

PubMed2006

Association between antidepressant prescribing and suicide in Israel.

The effects of antidepressants on suicide are controversial; on the one hand they decrease the incidence of death by suicide, as reflected in epidemiological studies, and on the other hand, there are claims that they increase the risk of impulsivity and suicide. In 1998, primary care physicians in Israel were not allowed to prescribe selective serotonin reuptake inhibitors and in 1999 this prohibition was lifted. We thus evaluated the association between patterns of antidepressant prescribing and the rate of death by suicide in Israel in 1998 compared with that in 2002. Data regarding deaths by suicide were obtained from the Central Bureau of Statistics. Annual rates of antidepressant prescribing were computed from the Intercontinental Marketing Services database. The Intercontinental Marketing Services data covers three out of the four Health Maintenance Organizations in Israel, encompassing 46% of all citizens. Prescribing of all antidepressants increased 2.6-fold between 1998 and 2002. This increase was significantly more pronounced for the selective serotonin reuptake inhibitors. A shift in prescription practices was noted, with a 1.37-fold increase in prescribing by primary care physicians. While the concomitant decrease in overall national rates of completed suicide did not reach significance (17-14 per 100,000), the incidence decreased significantly in men aged 55-74 years (33-22 per 100,000; P=0.029). An overall reduction in suicides, which was significant only in elderly men, was noted in association with increased rates of antidepressant prescription. This study is limited in scope but adds a unique viewpoint related to the possible positive effect of increased antidepressant prescribing in primary care on suicide.

Aged↗

PubMed2006

Intramuscular ziprasidone treatment of acute psychotic agitation in elderly patients with schizophrenia.

OBJECTIVE: Intramuscular (i.m.) ziprasidone treatment has been shown to be effective and well tolerated in reducing the symptoms of acute psychosis in adults. Few data are available as to safety in the elderly. The growing utilization of health services by elderly psychiatric patients warrants an evaluation in this population. METHOD: Consecutive elderly patients (60 years of and older) admitted to a psychogeriatric ward in a large, university-affiliated tertiary psychiatric center were treated by i.m. ziprasidone for acute psychotic agitation. Patients received three days of flexible-dose i.m. ziprasidone. After an initial dose of 10-20 mg, a subsequent dose of 10-20 mg could be given after 12 hours if needed (maximum daily dose: 40 mg). RESULTS: All treatment emergent side effects and adverse events along with the investigators' assessments of severity were systematically recorded as the primary outcome. The Brief Psychiatric Rating Scale (BPRS) and the Behavioral Activity Rating Scale (BARS) were the secondary outcomes. Twenty-one patients, six male and 15 female, mean age 71.4 +/- 1.3 years (range: 60-81 years) were enrolled. All had completed the three days i.m. ziprasidone treatment. There was one adverse event in a patient with untreated benign prostatic hypertrophy who developed urinary retention. Two side effects of mild severity that resolved spontaneously were observed: blurred vision and sedation. The BPRS decreased by 26.8 points after three days of treatment (p = 0.001). The BARS score, reflecting agitation, decreased significantly after each injection, reaching maximal decrease of 2.14 points at completion of study (p = 0.001). CONCLUSION: Intramuscular ziprasidone in this series of elderly patients suggests acceptable safety and efficacy in the management of acute psychotic agitation among elderly patients with schizophrenia.

Acute Disease↗

PubMed2006

New enzyme for reductive cancer chemotherapy, YieF, and its improvement by directed evolution.

Reductive prodrugs, mitomycin C and 5-aziridinyl-2,4-dinitrobenzamide (CB 1954), are nontoxic in their native form but become highly toxic upon reduction. Their effectiveness in cancer chemotherapy can be enhanced by delivering to tumors enzymes with improved prodrug reduction kinetics. We report the discovery of a new prodrug-reducing enzyme, YieF, from Escherichia coli, and the improvement of its kinetics for reducing mitomycin C and CB 1954. A YieF-derived enzyme, Y6, killed HeLa spinner cells with >or=5-fold efficiency than the wild-type enzymes, YieF and NfsA, at a variety of drug and enzyme concentrations and incubation times. With adhered HeLa cells and Salmonella typhimurium SL 7838 bacteria as enzyme delivery vehicle, at least an order of magnitude less of Y6-producing bacteria were required to kill >90% of tumor cells compared with bacteria expressing the wild-type enzymes, which at a comparable level killed < 5% of the cells. Thus, Y6 is a promising enzyme for use in cancer chemotherapy, and Salmonella strain SL 7838, which specifically targets tumors, may be used to deliver the prodrug-activating enzymes to tumors.

Antineoplastic Agents↗

PubMed2005

Reduced cancer incidence among patients with schizophrenia.

BACKGROUND: The incidence of cancer in patients with schizophrenia has been conversely reported to be higher, lower, or similar to that in the general population. The effects of lifestyle factors such as excess smoking, exposure to neuroleptic medications, and genetic factors that may influence the incidence of cancer in this group are not clear. The current study was performed to evaluate the frequency of cancer in a large cohort of patients with schizophrenia and to determine the standardized incidence ratios (SIRs) of any malignancy in this group. METHODS: Data regarding the design, setting, and participants of the current study were analyzed from a cohort of 3226 patients with schizophrenia who were enrolled in the computerized health registry of the Abarbanel Mental Health Center between 1993-2003. The mean age of the patients at the time of the diagnosis of cancer was 49 +/- 14.7 years, with the majority of patients (61%) being male. All patients with schizophrenia records in the database were combined with the records of the Israeli National Cancer Registry to identify pathologically confirmed cancer comorbidity. The cancer incidence rates among patients with schizophrenia were compared with the expected incidence in an age-matched and gender-matched general population sample for the same time interval. RESULTS: Among 1247 female patients with schizophrenia, 22 (1.8%) developed breast cancer and 68 (5.5%) developed cancers of any type. Fifty-two of the 1979 male schizophrenic patients (2.6%) developed cancer. The SIRs were 0.58 (95% confidence interval [95% CI], 0.48-0.69) with a P value of < 0.05 for all cancers in the cohort, and 0.60 (95% CI, 0.37-0.90) for female breast cancer. CONCLUSIONS: The results of the current study demonstrate a reduced risk of cancer in patients with schizophrenia. The mechanisms responsible for the lower risk need be investigated further.

Adult↗

PubMed2005

Cancer incidence in multiple sclerosis and effects of immunomodulatory treatments.

Multiple sclerosis (MS) has been linked to reduced rates of cancer prior to the era of immunomodulating treatments. We assessed the incidence of cancer in a cohort of 1338 MS patients and evaluated the effect of exposure to immunomodulatory treatment. Cancer incidence in the MS population was compared with the expected age- and gender-matched incidence rates in the Israeli population for the period 1960-2003. Time-dependant Cox model analysis was used to estimate hazard ratios for glatiramer acetate, beta-interferons (1a and 1-b) and intravenous immunoglobulins (IVIg). Among 892 female MS patients, 15 (1.7%) developed breast cancer, and 31 (3.5%) developed cancers of any type. Seventeen of 446 (3.8%) male MS patients developed cancer. The standardized incidence ratios (SIRs) computed until the time of first immunomodulatory treatment were 0.60 (95% CI, 0.38-0.92, p = 0.02) for all female cancer, and 1.11 (95% CI, 0.64-1.91) for all male cancer. Time-dependent covariate analyses for female breast cancer yielded a relative risk for glatiramer acetate of 3.10 (95% CI, 0.86-11.1) and 0.52 (95% CI, 0.07-4.05) for beta-interferons. For IVIg, the analyses were uninformative. Our findings indicate that cancer incidence is significantly lower in female MS patients than in the general population. Female MS patients treated with glatiramer acetate showed an elevated rate of breast cancer and all MS patients treated with beta-interferons showed an elevated risk of non-breast cancers though not statistically significant (p = 0.122 and 0.072, respectively). Further study is needed to assess possible associations between long-term exposure to the novel immunomodulatory treatments in MS and rate of cancer.

Adjuvants, Immunologic↗

PubMed2005

Affective psychosis following Accutane (isotretinoin) treatment.

Isotretinoin (Accutane) ranks in the top 10 of the US Food and Drug Administration's database of drugs associated with reports of depression and suicide attempts. However, this association is still controversial because up to 5.6% of patients with moderate acne may have pre-existing suicidal ideations, improvement of acne often reduces associated depression, and isotretinoin users are reportedly no more likely than those taking antibiotics for acne to have depression or commit suicide. We describe a series of cases of manic psychosis that developed in a 1-year period (2003) in association with isotretinoin treatment and resulted in suicidality and progression to long-standing psychosis. Cases were drawn from 500 soldiers who had been evaluated in a military specialists dermatology clinic for severe acne. Data were summarized from medical records of five severe acne patients treated by isotretinion during their compulsory military service. Data from their draft board examinations and service records, as well as repeated clinical assessments by certified psychiatrists at the Israel Defense Forces (IDF) Mental Health Department clinic, were evaluated. Five young adults developed manic psychosis within a mean of 7.6 months of exposure to isotretinoin. In three cases, this was accompanied by a suicide attempt, and in three cases, psychosis lasted for longer than 6 months. Either a personal history of obsessive-compulsive disorder, neurological insult or family history of a major psychiatric illness were present in all cases. The present case-series is suggestive of an increase in the likelihood of an association between exposure to isotretinion and manic psychosis. Associated risk factors were both family and personal history of psychiatric morbidity. Further studies are needed to establish our findings.

Acne Vulgaris↗

PubMed2005

Assessing cardiovascular risks of olanzapine treatment: a 6-month study versus haloperidol in schizophrenia patients.

The introduction of second generation antipsychotics (SGA) represents a major advance in the treatment of schizophrenia. Concerns about the metabolic and cardiovascular adverse effects of the SGA have been widely disseminated. The benefits and risks of these drugs have been studied with a focus on particular organ systems. A basic principle of prevention is that the intensity of risk-reduction therapy should be adjusted to a individual's absolute risk. Hence, the first step is to assess an individual's risk status. The present study was designed to evaluate whether there is an added cardiovascular disease (CVD) risk in switching schizophrenia patients from typical antipsychotics to the SGA olanzapine. Risk status was determined by a 10-year risk assessment as recommended by the USA National Heart, Lung, and Blood Institute. This was carried out with Framingham scoring to identify individuals whose short-term (10-year) risk warrants consideration of intensive treatment. This risk was calculated for schizophrenia patients who were treated by haloperidol for a minimum period of 6 months and again following 6 months of exposure to olanzapine. Forty-three patients fulfilled inclusion criteria. There were 25 male and 18 female patients (mean age 40.7+/-2.4 years). The mean 10-year percentage risk of CVD for the group while on haloperidol treatment was 4.58+/-0.9 and, after 6 months of exposure to olanzapine, this was reduced to 4.12+/-0.9. Changes in the total risk and each evaluated risk variable were not statistically significant, except for a decrease in resting systolic blood pressure. Switching schizophrenia patients from typical antipsychotic treatment to olanzapine is safe and does not increase the long-term risk of cardiovascular disease.

Adult↗

PubMed2005

Patients with very-late-onset schizophrenia-like psychosis: a follow-up study.

OBJECTIVE: The topic of course and outcome of very-late-onset schizophrenia-like psychosis (VLOSLP) has not received the research attention it deserves. The aim of this study was to evaluate the course of clinical symptoms and functional status of patients with VLOSLP in comparison with patients with life-long schizophrenia. METHODS: Telephone interviews were conducted on primary caregivers of 21 patients with VLOSLP who had recently been released from inpatient care. Their treating staff evaluated 21 schizophrenia inpatients according to the same criteria. RESULTS: The majority of patients with VLOSLP did not present cognitive and functional deterioration. On the other hand, 8 of the 19 patients in the elderly schizophrenia group had some functional decline; 3 of those 8 patients seemed to have some cognitive decline, as well. CONCLUSIONS: The results suggest that the VLOSLP patients present stable cognitive and everyday functioning, as compared with chronically institutionalized elderly patients with schizophrenia.

Activities of Daily Living↗

PubMed2005

Increased risk of attempted suicide among aging holocaust survivors.

OBJECTIVE: Suicide rates are higher in elderly persons than in those at other phase of the life-cycle. The majority of World War II (WWII) veterans and Holocaust survivors still define their war experiences as being the "most significant stressor" of their lives. Aging of survivors is frequently associated with depression, reactivation of traumatic syndromes, physical disorders, loss, and psychological distress, possibly increasing the risk of suicide. The aim of the present study was to investigate, among a large cohort of elderly Holocaust survivors, whether their WWII experiences confer an increased risk of suicidal behavior. METHODS: All medical records of elderly patients admitted to a psychiatric hospital in Israel during a 5-year period were retrospectively evaluated. Suicidal patients were compared with patients who had not attempted suicide. RESULTS: Of 921 eligible patients, 374 were Holocaust survivors; 135 (14.6%) had attempted suicide in the month before admission. Ninety Holocaust survivors (24%) had attempted suicide, versus 45 of the 502 patients (8.2%) with no WWII experience. The risk of attempted suicide among Holocaust survivors was significantly increased. CONCLUSION: Although these findings are from a highly selected sample, we suggest that aging Holocaust survivors are at increased risk of attempting suicide. The growth of the elderly population, of whom many had had traumatic life experiences, emphasizes the need to implement preventive strategies so that suicidal risk may be contained.

Age Factors↗

PubMed2005

[Pharmacotherapy in schizophrenia--comparison of second generation antipsychotic agents].

Schizophrenia is a severely limiting chronic illness. The disease is characterized by periods of psychoses, remission, and sometimes even recovery. Effective pharmacotherapy for schizophrenia began with the development of antipsychotic neuroleptics in the 1950's, followed by the second generation of antipsychotic agents developed in the 1990's. Across time, treatment with some of these preparations revealed extrapyramidal and other side effects, including metabolic phenomenon, such as: an increase in the incidence of diabetes, and weight gain. When choosing the appropriate medication from among the second generation of antipsychotic agents, the following aspects should be considered; cost, efficacy, unique advantages, employment rehabilitation, relapse and metabolic side effects. Therapeutic algorithms and recommended guidelines are helpful when planning treatment strategies. Information regarding prior beneficial treatments, cost, and the patient's quality of life should be considered. Today, when patients' rights, economic and legal aspects are emphasized, the physician must take into account multiple factors when choosing the most appropriate treatment for the patient.

Algorithms↗

PubMed2005

Disordered eating in elderly female patients diagnosed with chronic schizophrenia.

BACKGROUND: Data about the association between disordered eating and schizophrenia is limited and inconclusive. The aim of the present study was to evaluate disordered eating in elderly female patients diagnosed with chronic schizophrenia. METHODS: The Eating Attitudes Test-26 (EAT-26) was completed by 30 female inpatients diagnosed with chronic schizophrenia (mean age 70 +/- 6.5 years), and the Geriatric Depression Scale (GDS) and Positive and Negative Symptom Scale (PANSS) were completed by their treating psychiatrists. The height and weight of the patients were also recorded. RESULTS: Four patients (13.3%) had pathological scores on the EAT. These patients had lower body mass index scores and longer duration of hospitalization compared with the other patients. Their eating-related disturbance was anorectic-like in nature. There were no between group differences in the GDS, whereas the schizophrenic illness of the four patients with pathological EAT, as rated with the PANSS, appeared somewhat more active. CONCLUSIONS: Disordered eating of an anorectic-restrictive nature--not related to depression or negative schizophrenic symptomatology--may be found in a relatively high percentage of elderly female inpatients diagnosed with chronic schizophrenia.

Aged↗

PubMed2004

Suicide attempts amongst elderly schizophrenia patients: a 10-year case-control study.

BACKGROUND: Suicide is frequent amongst the elderly. Schizophrenia is one of the disorders in which suicide attempts and death by suicide are pronounced. However, there is paucity of data regarding suicide attempts by elderly schizophrenia patients. The aim of the present study was to characterize elderly schizophrenia patients who had attempted suicide (AS). METHOD: Over a 10-year period, all computerized records of admissions of schizophrenia patients 60 years or older were examined. Patients who had attempted suicide were defined as the index group and the comparison group was comprised of the next two admissions suffering from schizophrenia who did not attempt suicide prior to hospitalization. RESULTS: 1066 admissions of patients 60 years or older suffering from schizophrenia were examined. There were 392 women and 300 men, mean age for the group 67.4 years. Forty-nine suicide attempts were documented comprising 4.6% of the admissions. Attempts were carried out by 30 patients of whom 10 had had attempted suicide more than once. There was an almost significant difference on gender composition with more males in the suicidal group. No other variables tested were positively associated with suicidality. CONCLUSIONS: The present study is unique in its scope and targeting elderly schizophrenia patients. Despite the lack of identified risk factors, further studies focusing on aging schizophrenia patients are needed as low base rate of suicide exists in this group.

Aged↗